The recent Blog, “The Language of Resilience” by Dr. Les Kertay, answers the question what is Critical Incident Response (CIR) for and what is the expected outcome of CIR? Many of the events Critical Incident Response is used for are not typically thought of as a Critical Incident. Thinking in terms of “Critical Incidents” may lead us to assume pathology when the most common outcome to any stressful event is resilience. Dr. Kertay suggests a more accurate term is “Potentially Disruptive Event” as humans are developed to endure stress, manage its effects, and return to life, often more resilient than before. Providing guidance and support to this natural process of resilience is the purview of CIR.

Dr. Les Kertay is a Licensed and Board Certified Clinical Psychologist with extensive experience in mind-body health including disability medicine, chronic pain, and health behaviors as well as being a leader and consultant on strategies to manage workplace absence and a practicing clinician and industry consultant. Dr. Kertay is currently Chief Medical Officer with R3 Continuum (Crisis Management International, Crisis Care Network, Behavioral Medical Interventions).

When I talk to clients about their family upbringing, I often get the response, "We had food on the table, a roof over our heads and clothes to wear".There is so much this description leaves out.

Abraham Maslow developed his well known Hierarchy of Needs including food, shelter and safety.What is left out, is what I call the three A's required to maximize our life experience …

Approval.

As children, we need to know our right to be on this planet and in the lives of those who raise us is never in question.Parents have what children perceive as ultimate authority over their lives. The parent who abuses that can put the child in a state of mortal fear, creating a foundation for emotional problems.Children should hear, "We brought you into this world and welcome you as part of our lives", or, for adoptees, "We chose to make you part of our family, no less than any other child we have or may have in the future".The extraordinary power parents have needs to be put to use for children, not against them.This does not mean all behavior is acceptable, but that a child's life has inherent validity.

Affirmation.

This may sound like a synonym for approval, but it goes further.The idea behind affirmation is that a child's character is never in question.Mistakes in judgment are not "flaws", but are: mistakes, pure and simple.Affirmed children and, later, adults, are better able to stand on their own making important decisions and not second guessing themselves with regard to their essential integrity.Affirmation continues beyond age 18.Children outgrow their need for approval, but the need for affirmation, be it quiet or loud, continues.Healthy affirmation outlives us and is an important gift to those we love.

Affection.

The importance of physical affection has been scientifically and anecdotally validated.Babies physically wither if they are not held and stroked.The effects of withholding of affection have been demonstrated in children raised in institutions that do not offer healing touch.Touch creates a bridge between what is spoken by voice and meant by intention. Couples are clear that affection is often as important as sex; in a world where they have given each other permission to share what they would not share with anyone else, the daily small demonstrations of intimate attention carry great meaning, affirmation of their mutual attraction to each other.This carries a powerful message of safety, as well.

Approval, affirmation, and affection must coexist with each other.There is little chance of success if one is left out, or one emphasized more than the other, unless there is a particular need to do so.People can withstand incredibly difficult circumstances and thrive with these elements in place.

Gilbert Bliss is a Psychotherapist in private practice in Towson, Maryland.His experience includes work with individuals, couples, families and children in bereavement.His web site is www.gblisscounselor.com.

I have had the privilege of working with patients who have had sexual trauma early in their lives, either as children or young adults.As a result of this opportunity, I have come to believe that it can be important for some who have experienced such a terrible experience, either once or over time, to work with a therapist of the same gender as the abuser.While I do not, in any way, believe that anyone should seek the advice of a therapist with whom they would experience immediate discomfort, I am of the deep conviction that a healing relationship with a therapist of the same gender as the abuser could help to lift the limitations a patient might feel with regard to letting themselves be available for a meaningful relationship with another person.

Such a venture is a very tender process, involving time and an openness of expression that could help a patient be liberated of old fears while becoming wise about how to best take care of themselves in situations that, after working through the trauma, might otherwise make them too anxious to allow involvement.This is the process of moving from the position of victim to permission to thrive, perhaps on an even higher level than even the patient might have allowed themselves to consider.

As with any patient I see, my approach is collaborative.If a patient is too uncomfortable with the work we are doing, I change my approach to take their feelings into account.If the work just feels like it is "too much", we take a break.No one should feel like a prisoner to the therapeutic endeavor.

I invite people who have had such difficult experiences to consider what, to some of my colleagues, seems a radical approach.I would hope that the discovery would be that there is nothing to lose but some time.

Gil Bliss is a Licensed Certified Social Worker-Clinical (LCSW-C) with a private psychotherapy practice in Towson, Maryland.Gil has worked with a wide variety of patients, including individuals, couples and families, along with grief work with children.His web site is www.gblisscounselor.com.